Posted
by
Soulskill
on Saturday May 02, 2009 @12:13AM
from the correlation-is-reeeally-chill-man dept.

SpuriousLogic writes "Drinking water which contains lithium may reduce the risk of suicide, a Japanese study suggests. Researchers compared levels of lithium in drinking water to suicide rates in the prefecture of Oita, which has a population of more than one million. The suicide rate was significantly lower in those areas with the highest levels of lithium, they wrote in the British Journal of Psychiatry. And I was only worried about fluoridation affecting my precious bodily fluids before ..."

I'm so happy 'cause todayI found my friendsThey're in my headI'm so ugly, that's okay'Cause so are youBroke our mirrorsSunday morning is everydayFor all I careAnd I'm not scaredLight my candles, in a daze'Cause I've found God

Yeah yeah yeah yeahYeah yeah yeah yeahYeah yeah yeah yeahYeah

I'm so lonely, that's okI shaved my headAnd I'm not sadAnd just maybeI'm to blame for all I've heardI'm not sureI'm so excitedI can't wait to meet you thereAnd I don't careI'm so horny, that's okayMy will is good

For those that do not know, lithium is a commonly prescribed medication for people with bipolar/manic depression disorder. Suicide is the only top 10-20 killer among all age groups in the US. The people most likely to commit suicide are bipolar people as opposed to people who are "normal" or those with other psychiatric disorders (major/minor depression, schizophrenia, etc). Similar studies to the one in this story have been done in Texas where lithium levels in the water supply are significantly above average compared to other states and the hospitalizations and suicide rate of bipolar people are less in Texas than other states. Yes, these studies are correlational, but anyone with a basic knowledge of statistics knows that correlation is well beyond the mantra shouted here that "correlation != causation".

Case in point with Nirvana's Lithium lyrics, the author of the song, Kurt Cobain [wikipedia.org], was bipolar, and he is now dead from suicide. The reason suicide is so common with bipolar people is because it is so difficult for them to handle the swings from the feelings of mania and euphoria down to the feelings of worthlessness and despair. Also, heavy substance abuse, particularly with central nervous system depressants like alcohol and heroin are common among bipolar people because they temporarily relieve stress (a trigger for instability) and well alcohol and heroin are quite pleasant drugs to do in the first place. Its not uncommon for them to semi-regularly do drugs like cocaine, MDMA, or LSD to bring back the familiar feelings of mania and euphoria.

Its common for the drug use or other unconventional social behaviors to be incorrectly deemed as causal towards the feelings and behaviors of people with bipolar disorder. I know someone very well who has bipolar disorder who has gone back and forth between a highly functional, well educated, intelligent, middle-class professional to chronic alcoholism, homelessness, in and out of jail and unemployment, to back again to the functional part. In our society, its not very permitted for people to take weeks, months or years away from activities like work or school which is what most people do from 5-65 years of age, and any and all deviations from consistency are heavily punished due to lower pay, lack of promotions, loss of jobs, jail, hospitalization, etc, which is enough to make any "normal" person depressed.

I resemble this remark. Fortunately for me, there is a mineral hot spring LOADED with lithium an hour away from me.

So, ah, I'm curious. Who else here has this problem, and how bad? I'm cyclothymic, which is a pretty mild version of bipolor disorder, and I've been keeping it (mostly) under control with sertraline.

I've had suicidal ideation, mainly as a teen, but no actual attempts. Mostly, I just get totally manic about a project for a month or two, and have a hard time sleeping, eating, or focusing on anything else. Then a couple weeks of normal. Then a month or two of eating too much and not being able to focus on anything, then a week or two of normal again.

Too much of something good can be very bad. Take Vitamin A [wikipedia.org] for example. If you don't have enough, you get troubles with skin, bones, vision, even your DNA. Too much can make you lose hair, have the shits like you've been sucking on a water faucet in Mexico, anemia and so on.

You want to take exactly the right amount of a stuff to stay healthy. And for a healthy person, the exactly right amount of a drug is zero.

Patent? Lithium [wikipedia.org]? It's an element on the periodic table. How could it possibly have ever had a patent filed against it?

Because the actual drug isn't the only thing you can get a patent on. There's a fair bit of technology behind the manufacture and operation of pills and other drug-delivery systems. If a manufacturer managed to come up with a better way to deliver a clinical dose, I'd think it could be patented. And maybe you can't patent an element, but I suspect (given the USPTO's penchant for issuing marginal if not outright bogus patents lately) you could patent that element as a treatment for a specific ailment. Don't confuse what should be unpatentable for what actually isn't. Not anymore.

Elemental lithium isn't used as an anti-depressant - I don't think your body would be too pleased if you swallowed a lump of the stuff.
However, lithiums salts, such as lithium carbonate, are used as anti-depressants.

I think your point still stands, as lithium carbonate is a pretty simple probably naturally occurring molecule and this should affect whether is patent is granted. However, some of the other lithium salts used as anti-depressants are more complex, probably harder to derive and are arguably m

as a person who took lithium for years, i would like to point the kind readers to Lithium toxicity [drugs.com]. regular blood tests are highly recommended to prevent your blood from going toxic and killing your ass. while lithium bicarbonate [google.com] worked well for me for several years, the side effects got worse and the drug became ineffective.the toxic levels for lithium are close to the therapeutic levels.

It's still very widely prescribed for bipolar disorder. In mild cases, such as cyclothemia, the therapeutic doses are way below the toxicity level, unlike full-blown cases. There has been great success in recent years with low doses (200-600mg per day) in sub-clinic bipolar cases. I know several people who were either prescribed it immediately, or switched to it from more modern drugs.

Concidering that Lithium is used to treat a number of mental illnesses like bipolar and depression that should be expected. Here in the US there are many living with undiagnosed depression and we are seen as a tollerant and accepting society in regards to mental health. In Japan there is far less social acceptance (at least when I lived there, maybe its changed) so I would expect and even higher percentage of non treated people.

Manic episodes are definitely not "irrationally and exceptionally happy" and are very often extremely unpleasant.

Lithium acts as a mood stabilizer and works on both depression and mania.

The post you replied to is exactly right. In places with a mood stabilizing chemical in the water, suicide rates are lower. Fairly unsurprising except that the amount of lithium being dealt with is probably well below the known therapeutic threshold.

Lithium is basically a "mood stabilizer" and is increasingly used in recalcitrant depression (plenty of stuff on the web), albeit at much higher doses than what is found in drinking water.

Just glancing at the study, it's an interesting correlation, but it's going to be hard to do much with this. Just imagine the anti-floridation crowd going ballistic if anyone suggested adding Lithium to municipal water supplies.

In fact, it's the complete opposite: depressed people are much more complacent than not. Depression is not "being sad."

If you'd ever met a bipolar person you'd know what I mean. In their manic phases they'd go fight an army by themselves, they don't care about rules and retribution. In their depressed phase they can't get out of bed, let alone rebel against the established social order.

One of the biggest challenges in diagnosis and treatment of these diseases is defining the terms accurately in a clinically relevant manner. You got the depression part sort of correct, but bipolar disorders encompass a wide variety of symptom presentations. The "classic" manic depressive who might behave as you describe is called "type 1 bipolar disorder", but with type 2 bipolar disorder people are generally depressed with moods cycling downward toward more severe depression, although moods may swing upward toward hypomania. There's also a wide variety in the duration of the cycling, to the point where it may not be apparently different from normal mood changes.

Ultimately what we are talking about is the behavioral presentation of differences in brain structure and chemistry. On the surface what clinicians try to do is balance neurotransmitters using medications, but in practice what often happens is they merely try a series of medications until they hit on something that works. The effects of lithium are specific enough that it can almost be used diagnostically.

The interesting question raised here is when a naturally occurring substance becomes a drug. This question has been raging for years around fluoride. As a public health measure fluoridation is measurably effective but people question whether dental health is a sufficiently important reason to add a substance to drinking water. Iodized salt prevents an actual medical problem and goiter is now virtually unknown. Is the iodine a nutrient or a drug? What about fluoride? It seems to me that addition of lithium to the water supply would clearly fall under the definition of a drug. Even if it reduces the rate of suicide and mental illness the precedent set for "drugging the public" is far too serious and impinges on the rights of people who do not have a mental illness or chemical imbalances.

Treatment of mental illness must remain between a doctor and patient. The main benefit of this study is to increase public awareness of mental health issues, especially in a culture where mental illness is stigmatized.

You don't have to add it to the water anymore. Just implement a 'waste water treatment' plant to purify the water enough for watering lawns and golf courses. Then treat the local river water for municipal drinking supply. Wait till the pill popping house wives take lithium, and presto, profit!

And if you have to ask what ??? step is, read up on the high levels of birth control hormones in tap water and how they got there.

And maybe the real problem is that the body needs a certain amount of lithium to be stable, but some people need it more than other due to genetic predisposition.

And if we get it through water or through food is a different issue. One contributing fact can also be that we use pure sodium chloride in our cooking instead of a mix of salts where lithium and potassium also are present.

But it's probably best to avoid chewing on those LiIon batteries. But eating vegetables [naturalhea...niques.com] seems to be a good idea.

from that wiki link - "The most common side effects of lithium are thirst and polyuria."
So lithium in the water would make people drink more water and get more lithum which makes them drink more water and get more... oh the humanity!

It may not be promoted but is still taught in school as an appropriate mood stabilizer and is commonly used to treat bipolar disorder. I think concern over nephrogenic diabetes insipidus may be more of a limitation in its clinical use.

It can also cause thyroid problems and kidney failure. Patients must undergo very stringent tests to see if their body can cope with lithium, before it is given to them.

The problem is, lithium is highly toxic only very slightly above the theraputic threshold, making it extremely dangerous. Failure to drink, or sweating too much, will cause the lithium concentration to become dangerous or possibly deadly.

Well, that's -a- problem. Another is that it massively reduces the seizure threshold, so anyone potentially subject to seizures must also be put on anti-seizure medication to cancel the side-effect or risk having their brain turn into swiss cheese. However, each time you add medicines, you add risk of an abreaction to the new medication and also risk of the medications interacting in harmful ways.

(Many who die of medications they were prescribed die because the medications interacted.)

Despite Lithium being one of the longest-used medications for mental healthcare, it is still not very well understood. Patients are tried on it to see if it'll work for them, because it works much of the time. If it doesn't work, the doctor will try something else at random, and keep on going until something does work.

Why there haven't been studies using Lithium isotopes to trace the effects and identify the specific class(es) of condition(s) Lithium can deal with and which it can't, I don't know. It would seem easy enough and it would reduce the randomness in the mental healthcare industry.

What you say used to be true a couple of decades ago when lithium was mainly used in the treatment of "full-blown" type I bipolar disorder. This is what used to be called manic depression before the bipolar disorders were re-classified. In that case a therapeutic does is 1-1.5g lithium per day and toxicity is a major concern, especially over the decades that the drug may be administered for.

Medicine has come up with lots of different replacements drugs that work well in those chronic cases and so the prescr

HS chem may be a fading memory but aren't hydrogen and oxygen gases? so why is water a liquid? so confused:(

Oxygen atoms have a larger nucleus than hydrogen atoms, so in water, the shared electrons spend more time on average near the oxygen end of the molecule than the hydrogen ends. Because of this, the oxygen end has a negative and the hydrogen ends have a positive electric charge. Consequently, nearby water molecules will form networks, with one of the hydrogen atoms in one molecule being attracted to the oxygen atoms in another. This attractive force keeps the molecules partially bonded to each other, the state we call "liquid", in surprisingly high temperatures relative to water's molecular weight.

Perhaps the bigger problem is this: I once dated a young woman who had lithium treatments for bipolar disorder and, as a result, had to constantly get her blood tested to make sure it wasn't at toxic levels.

Yes, in certain amounts, lithium helps, but in larger amounts, it is toxic to the human body. If we put it in something like water, how are we going to explain to people that drinking too much water might cause bone loss, kidney damage and seizures? This is not to mention the problems lithium can c

The idea that "scientists" are going to be spiking water supply with Li+, a freaking powerful mood stabilizing aka mood altering drug for the "Greater Good"?! My wildly successful but bipolar Boss took this stuff to deal with his manic lows, and it he would become a zombie. Everything he accomplished as a businessman he did BEFORE taking lithium. I would rather see funding and energy expended to reduce suicides without "stabilizing" the humanity into a calm herd.

Please could you cut it with the FUD? Evil politicians are neither communists or capitalists, they are fascists, they'll pay lip service to anyone as long as they can have as much power and money as possible.

The idea that "scientists" are going to be spiking water supply with Li+, a freaking powerful mood stabilizing aka mood altering drug for the "Greater Good"?! My wildly successful but bipolar Boss took this stuff to deal with his manic lows, and it he would become a zombie. Everything he accomplished as a businessman he did BEFORE taking lithium. I would rather see funding and energy expended to reduce suicides without "stabilizing" the humanity into a calm herd.

I now want the government to stay away from my precious bodily fluids, though I didn't complain about flouride.

Well, my first response is "F*** That!". But on further reflection, I seriously doubt it's something to worry about, except in our most Orwellian of nightmares. Who'd approve such an extreme approach, save those desiring world domination? More importantly, who'd drink it?
I suspect the study had more to do with curiosity than malicious intent. All of the conspiracy laced subtext appears when a news reporter gets a hold of it. Sensationalism sells, and that's all this is.

I don't think anyone's saying anything about scientists PUTTING lithium into the water. They went around and measured levels of lithium already in the water and found that the areas with higher levels had less suicides. Seems like other factors could be at play here too, considering that geographic areas are often different from one another in many societal aspects.

I don't think anyone's saying anything about scientists PUTTING lithium into the water. They went around and measured levels of lithium already in the water and found that the areas with higher levels had less suicides.

I suppose all water has some level of lithium. Maybe people evolved for lithium-rich water (compared to the worldwide average today) and millions of people worldwide are actually suffering from lithium deficiency. Heck, it even kills some of them.

Why is being calm equated to being a zombie or being in a herd? Im certainly not advocating spiking the water with anything but fluoride, but its interesting how we react to news like this. We completely accept the speedy society. Hell, politicans and business want us to be stressed out and speedy. They want us to gulp down more afternoon coffee, red bull, bawls, soda, sugar, etc. It makes you more productive right? So, now youre doing the work of two people and catching up on your deadlines. Its not their concern that youre slowly developing heart disease or that youre anxious all the time and finally end up crashing around 3 or 4pm only to go home and veg out in front of the TV until bedtime to start the cycle over again. Theyre just happy they didnt have to hire an extra person in your department.

So, when someone suggests that calm might be better for you socially and medically, suddenly we're frothing at the mouth and jonsing for starbucks. I think this says a lot about modern society. Personally, I have no patience with the speedy types. You know, the over-worked person at your company who is on her third starbucks before 10am and wont stop talking your ear off or is buzzing around like a loon at all your meetings. Yeah, I want to work on a project with her.

Perhaps there's something to being in a calm town, regardless whether its water causing it or just people who want to be calm and happy instead of anxious and speedy.

"Im certainly not advocating spiking the water with anything but fluoride"

Does that mean that you do advocate putting fluoride in water? A chemical used in the treatment of hyperthyroidism (until safer alternatives where found)? I guess it would make sense that if you don't like overly-energetic people (which I'm not arguing with you about!) disrupting TSH receptor site activity within their thyroid gland with fluoride to slow their production of thyroxine probably would be a good thing... so was just wondering if you are a fluoride in water advocate, or whether you mean you're just abstaining from commenting on that one particular chemical? (or of course the option's there that I am mistaken with regards to the effect of fluoride on the thyroid)

It's not being calm that bothers me, it's the idea of creating and maintaining an extremely unhealthy society that naturally drives people over the edge and then suggesting a pharmaceutical band-aid as the 'solution'.

Western society has lost the wisdom of "haste makes waste" It values the snap decision even when there is plenty of time to think things through. Much of the workforce is kept much too "busy" for them to actually accomplish anything real.

Why not just flood all water supplies with every drug we can think of? Hey, thorazine seems to work! Is it really the governments job to inject vitamins/minerals/animals into our water supply? Sure, flouride seems to work, and I can see this study leading to lithium being added. I wonder if I could make Riddalin(sp?][TM] bottled water? Justs seems to be getting a bit nuts to me that we have to add something to everything.

for its ability to suppress suicidal urges. It's significantly more effective at suicide reduction than any other drug available. For this reason, it's still commonly used for treating people with bipolar. Ironically, it's also one of the more toxic drugs and easy to commit suicide with.

Having drugs that reduce the incidence of suicide is extremely important especially for bipolar. Post diagnosis, there is approximately a 15 to 20% suicide rate for bipolar patients. I was almost in that 15 to 20% I know very clearly why people try to end their lives and I also know that if they're not terminally ill, it can and should be prevented.

If a friend or family member is seriously down, withdraws from social circles (and not just because they're on a bataan death march coding project), start giving away belongings or are talking about how it hurts too much to stay alive, ask them these three questions.

Do you have a plan to kill yourself? (Ask how)do you have the materials to kill yourself with?Do you have a place/time for killing yourself?

A single yes means stay close, call mental health in the morning. Two yeses or more means get the person to the emergency room and tell the doctor about these questions and responses. If the person will not go with you, call the emergency room, tell them what's going on and they will send emergency personnel to help.

Almost all people thinking of suicide will give you signals and, even though they may not show it, want someone to stop them. Most importantly, if you try and they kill themselves anyway, don't blame yourself.

Then keep your death wish to yourself. But if you go around making it plain that you intend to take your own life, you make it other peoples' business. Since many people presenting as suicidal are beyond the capability to make a logical decision (people often come to deeply regret suicide attempts), confessing suicidal tendencies to other people puts them in the position of choosing between saving a life (at least temporarily), and potentially watching a preventable and tragic death. Regardless of what you want, it's inhumane to confess your shit to another person and then expect them to take any action other than the one that preempts exposure to guilt over a life lost.

I also know that if they're not terminally ill, it can and should be prevented.

Care to back up that assertion of moral authority? My body, my choice.

Nonsense. People that truly want to commit suicide will do it if they can. There's nothing you can do about it, and odds are, you'll never know anything until after it happens.

That's not the case with most attempted suicides, so this is NOT a "my body, my choice" scenario. An untimely (or even a timely) death has effects upon others that go far beyond the one individual that died. The one who suicided is beyond caring, but many other people can be damaged or destroyed by their "choice". Unless you are a

How do you make life not suck so much? Seriously -- is it better pay? Free sex? More leisure time? I am depressed about 90% of the time and have been since I was 16 (I'm 40 now). I work part-time (about 3 days/week on average), make a (barely) six figure income, and my wife is bi. I'm not making up a word of this. I should feel incredibly happy, but instead, a life-long sense of despair prevents exactly that.

I think there is a good part of depression that is due to external forces. I can say that when I was poor, it was worse. But a large part of depression is wholly internal and no amount of "making life suck less" is going to change that.

How do you make life not suck so much? Seriously -- is it better pay? Free sex? More leisure time? I am depressed about 90% of the time and have been since I was 16 (I'm 40 now). I work part-time (about 3 days/week on average), make a (barely) six figure income, and my wife is bi. I'm not making up a word of this. I should feel incredibly happy, but instead, a life-long sense of despair prevents exactly that.

I think there is a good part of depression that is due to external forces. I can say that when I was poor, it was worse. But a large part of depression is wholly internal and no amount of "making life suck less" is going to change that.

Perhaps if people didn't generally spend 1/7 of their life in a large building with a well-dressed man telling them they're going to hell because they were born a bad person, they'd feel better.

Better pay, free sex, and more leisure time are nice, but won't make you as happy as realizing that you really ARE a good person and accepting it. Accepting and living with it is probably more difficult in this sadist society.

Start by asking yourself:
If you could do anything, without limitations, what would you do?
If you could be anyone, make yourself become any kind of person, what kind of person would you be?
If you could have any life you wanted, what kind of life would you have?

I don't actually know anything about you, but these questions can help.

Ha, I count myself lucky to have been born where I was born, to always have had food and shelter, an education, and the ability to make my own mistakes and get to learn from them. In your case, I would suggest mountain climbing and skydiving, possibly base jumping after a while. Adrenaline, dopamine, and the fear of death do wonders for your appreciation of life. Short though it may be. Of course, changing your life based on a/. post may not be sane, but then very little is.

Funny thing about living through stressful difficult times is you learn to be content with what you have. I live in the third world under an undemocratic government and have a much lower standard of living than you guys, but I'm quite happy.

I'd say, its the old problem of the more you have, the more you want. Happiness has nothing to do with material wealth or possessions. Its a state of mind.

So can we ethically allow mind-altering substances that are naturally present to exist in the water supply? It's a tricky business the moment you cease drinking water from rivers or springs and start piping it anywhere. The people piping it suddenly have an ethical obligation regarding its contents.

This study was to identify potential NATURAL contaminants that alter emotional disposition. Nothing about changing the water supply. It is potentially interesting, in that it may change our understanding of suicidal behaviour from place to place, and our understanding of something as simple as the water supply's varied social effects.

When you drink tap water, you (presumably a healthy person) are consuming a substance that may or may not have mind-altering substances just naturally. Almost all chemicals have some negligible effect on the mind, some moreso than others. Your region probably hasn't been analysed for lithium concentrations; you could be in a naturally higher region for all you know. Are you being given a mind-altering substance without your consent? Quite possibly.

Or to put it another way... There are more shades of grey than there are in your morality.

Lithium is a hard-core drug used by psychiatrists. To quiet those, where nothing else helps anymore.It has tons of site-effects. And afterwards, you are usually not the same person anymore. Which may be good, if you were destroying the place, including yourself, before it. But it's bad in any other case.

Of course I don't know what the dose is that they put in the water. But if it changes people's behavior, it obviously has an effect.

I know this, because a friend of mine was given this because of a feeling of extreme heart problems while trying to sleep. And when they noticed it did not help, he got something even stronger. He slept like a baby. But only as long as he was on the stuff. Typical symptom therapy with no care for the real cause.He was only healed (no problems and no "medicine") after a very intense psychotherapy.

If they would put lithium in my water, I would sue them for deliberate aggravated assault (or how the lawyers call it in the US) and and psycho-manipulation (something like that).Not funny. Not funny at all.

People, please stop tagging every study on Slashdot with correlationisnotcausation. I know it's standard here to believe this community is somehow more enlightened than all others, but do you really think that researchers became researchers without being able to ask simple questions? In fact, in an idealized study, it's not even a relevant question!

Moreover, this moronic practice is especially stupid for this story because the neurological effects of lithium salts have been explored for decades. This is not a revolutionary study by any means. So unless years and years of studies have gone horribly wrong, then yes, in this case, correlation does, in fact, imply causation.

People, please stop tagging every study on Slashdot with correlationisnotcausation. I know it's standard here to believe this community is somehow more enlightened than all others, but do you really think that researchers became researchers without being able to ask simple questions? In fact, in an idealized study, it's not even a relevant question!

Moreover, this moronic practice is especially stupid for this story because the neurological effects of lithium salts have been explored for decades. This is not a revolutionary study by any means. So unless years and years of studies have gone horribly wrong, then yes, in this case, correlation does, in fact, imply causation.

Actually, that's incorrect and reinforces that the correlationisnotcausation tag should still be used for these articles, because obviously even us intelligent Slashdotters can get confused!

While one might be able to say that lithium causes decreased suicides based on other data from other studies, one cannot infer from this study that the low lithium levels in the water (which would presumably not cause lithium blood levels in the range currently targeted for therapy) are what's responsible for the decreased rates. One can only claim correlation.

This is due to the possibility of confounding variables (for example, do wealthier neighborhoods tend to have more pure drinking water?).

Even if you control for all the factors that you know about that could cause such misinterpretation of the data, there is still a very real possibility of an unknown confounder (e.g., could there be another substance in the water that tends to track with lithium levels, and could it be that other substance that is the suicide-protective agent?)

FYI, lithium is not a heavy metal. It's the lightest metal, and 3rd lightest element, just behind hydrogen and helium.

That said, yes, it is quite toxic at the higher end of the therapeutic range, but the bottom end of the dosing range is about 5 orders of magnitude above the highest levels found in this (assuming an consumption of average of 3 litres per day), so I would think the toxic results from the naturally occurring lithium would be negligible.